Part 2 interview/Podcast with Robert Herzog, Founder & CEO of eCaring, a web-based home health care monitoring and management system that delivers real-time information from the home to care managers, providers, and family members that is transforming the home Healthcare Industry
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HIT Consultant: What are the broader implications of how eCaring can be used to improve chronic geriatric and home healthcare?
Herzog: Well, if you can be getting this kind of information in real time, if you got, let’s say if you 
have an adult with a chronic condition…or many adults have more than one chronic condition…they see their doctor or primary care physician or a visit to a community health center or they may have seen their specialist and then they go home. And they may be given a wellness plan. A plan to say, here are the things you need to do. But as one primary care physician said to me, they leave the office and their wellness plan unravels. It’s very hard to just get some information from the doctor or upon post discharge from the hospital, go home and be expected to remember and learn and do all that.
So, eCaring is a constant reinforcement to pay attention to yourself or if you’ve got homecare, people paying attention to the critical factors that are going to keep you as healthy as you can be and to keep the costs for care as low as possible. So, that’s true for chronic conditioned people whether they’re coming out of a hospital or just under a general wellness plan on how to take care of themselves…Taking their insulin on a regular basis. Seeing when their insulin spikes. What are the behaviors that cause that? Did they exercise too much? How much long or slow, fast or quick-acting or slow-acting did they take prior to this? What’s their eating pattern been? So you can get a record and you can identify patterns and you can start addressing changes in your behaviors that can do that.
There’s a lot of evidence that shows if people are paying attention to themselves and they feel somebody else is paying attention to them, then they’re performance is going to be a lot better. There’s going to be better adherence to plans of care, better adherence to taking medications and just better at taking care of yourself. So, for geriatrics with homecare or people living on their own or with family members, you get a much better level of adherence and understanding about what’s going to keep me healthy and at home longer. And the same is true for chronic conditioned patients where they can really understand what’s causing them problems, how to address those problems and how to intercept and make sure the problems don’t become more serious so that they don’t have a hospital visit or an ER visit or really something very costly and bad happen to them.
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HIT Consultant: From a provider perspective, what are the savings to be found using an HIT tool like eCaring?
Herzog: Well, from a provider perspective, particularly for providers who are involved in care management or responsibilities such as accountable care organizations or medical homes, geriatricians and geriatric faculty practices, any of the faculty practices,. When you use eCaring, what it means is that you have a current, up-to-date record about what’s happening to the patient in the patient’s environment, in their home settings and therefore you can make determinations with regards to the impact of medications, adjusting them…for example, we had one Beta site where a woman was just trying to get up a lot more in the middle of the night. And every time somebody gets up, even if it’s just to urinate, there’s an increase risk of fall. Maybe they’ve taken a change in medication, which is acting like a diuretic that was causing them to have to urinate more, that could also lead to a urinary tract infection to hallucinations and that ends up being an ambulance ride, an ER or hospital visit and maybe moving out of the home into institutional care…losing that patient for the provider because they have now moved to a different care setting.
So, with eCaring you can prevent these small problems from becoming big problems and doing so, you’re providing better care for your patient and you’re also lowering the costs for really high cost services that come in when systems don’t do everything that can do to keep the patients problems from becoming big ones. So from a provider perspective, you can manage a higher level patient load because you’re getting better information and more easy to read formats so you can more quickly assess a patient’s condition, you can get them what they need more quickly and you can intercept more quickly when they have problems in order to keep small problems from becoming big ones.
HIT Consultant: Now what about from a patient’s perspective…how does this technology help older folks or those with chronic conditions who choose to stay in the home instead of moving to a senior living facility?
Herzog: Sure and I think most people would much prefer to live in their home and even willing to pay extra for that…it’s a terrible thing when you have to move out your home or give up your driver’s license…that’s even worse, I think, for some people. It keeps them at home longer and it does that because they have the ability to directly communicate themselves with the people who are providing them with care services to communicate their current statuses and conditions. So, if all of a sudden, they’re sleeping more during the day or less…if they start skipping meals or eating meals less; if their behaviors change in a way that’s indicative of a problem…you have somebody looking over their shoulder…it’s like a virtual house call of somebody who can review their situation and say,” Ok we need to pay attention now”.
Without this kind of a system, it just wouldn’t get noticed. And a month from now it would end up being an ER visit, an ambulance ride, a hospital visit which…and more drugs, more treatment, more pressive environment with having to them move out of the home to another care setting. So this enables that home care, geriatric person to stay at home longer because they are going to be getting the best possible care to make sure that they don’t develop serious conditions that are going to force them to leave the home versus enabling them to stay there. It’s a huge benefit for them.
HIT Consultant: Now can you provide just maybe one or two specific examples of the populations that you are helping?
Herzog: Sure, we are working with Maimonides Hospital in Brooklyn. They have a geriatric faculty practice there and we will be setting up this summer, installing eCaring with patients in their geriatric faculty practice, in order to help that practice just manage the care of those patients a lot better. Right now, there’s a lot of paper, systems for tracking what’s going on in their home. It’s cumbersome. It takes a lot of time, the doctor’s time because we really want to cut the time that it takes the doctor to review that information by getting it in more useful form and more quickly exactly what they want and need and what they want to use. So, we’ll be working with them…
We’re taking with another hospital about managing…using eCaring with their congestive heart failure post discharge population in order to manage that population to prevent avoidable readmissions and again, provide, of course, just a better quality of care for those people when they leave the hospital. We’re working with some people in California on working with a community health center for adults with chronic conditions to manage their relationship to community health centers so they can get a better total level of care by communicating what’s happening in the home…back to the doctors and nurse practitioners and care managers so that they can track and intercept and make sure that serious problems could be avoided are avoided.
We’re working with another organization in California…a geriatric care management and home care agency so that their geriatric care managers can use eCaring as part of their services to their clients which is the patient in the home and the family for a much more comprehensive review of what‘s happening with that patient. And by the way it also helps geriatric care managers increase their caseload because it’s much better for them to get better information quicker about the total picture for each one of their patients and it really provides them a differentiation level of service to say to their clients, ”Look, we’re getting real-time, comprehensive, essential information about what’s happening in your mom or dad’s home to make sure they are getting the best possible care.”
So, we’re working in a variety of environments in order to provide the ability to get information out of the home and use that information in a way that keeps people at home longer and healthier and at lower cost.
HIT Consultant: So what’s next for eCaring?
Herzog: Well, we’re doing a combination of implementing…you can sign up today online at ecaring.com. And use our system on a one-on-one basis. We’re building out this new system where you can enter clinical data, vital signs and alerts so that you can get, either within the eCaring system or through an SMS or text message, so you’re carrying in your pocket a phone that with a comfort and a piece of mind that you’re going to be alerted immediately when there’s a problem. And then this is a system that is designed for care coordinators, case managers with a multiple patient load, 40-200 patients where they can easily look at their entire patient load, drill down to any one individual patient and see what’s going on there or look across the patient population for all the people who say, have had alerts for the last 24 hours or all their diabetics and start comparing outcomes based upon different conditions and treatment modalities.
So we are very actively engaged in both product development and in marketing where we are reaching out to organizations, such as accountable care organizations and medical homes and hospital discharge programs and faculty practices and geriatric care managers to work with them in developing a program that makes sense for them. So we’re building out these, what I would call, templates and things that are just designed for a specific kind of user and then working with terrific partners in developing these programs and then with that we will be going out providing them to organizations around the country and even internationally at some point.
HIT Consultant: Any final thoughts?
Herzog: My email address is Robert@ecaring.com . We’re actively seeking partners to work with in implementation…both individually and groups and organizations…for people who can represent us to various populations around the country. So, I welcome people to go online. They can try this system individually if they have the need or they can contact us in order to see about working together. We’re very excited. We have a lot of great things happening and we’re looking forward to working with lots of people.
To learn more about eCaring and how it works, click HERE
Podcast is also available in our iTunes store.
About Robert Herzog:
Robert has an extensive background in digital media and creative enterprises as an entrepreneur and executive. For several years he was deeply involved in the home and extended care of his mother Grace, which gave him an understanding of the problems eCaring is designed to solve.
He has been a pioneer in applying new technologies to business ventures, working as a senior executive with startup companies such as Motionbox, Diva, ON2 Corp, Softcom, Granite Films and City Winery, major corporations including JPMorgan Chase, Cahners Communications and the Sarnoff Research Center, and not-for-profits including New Jersey Appleseed and Ecotrust.
In public service, he was the creator and Director of New York City’s Energy Office, and also taught public school. Robert is also an author and filmmaker. He graduated from Williams College and has a Master’s from the New School.
